ʻO ka Metabolic Acidosis kahi maʻi e kū mai ana i ka wā e kaulike ʻole ai ke kaulike kemika o nā waikawa a me nā kumu i loko o kou koko. E noʻonoʻo e like me ka unahi kīhini. Inā ʻoe e kau i ke kaumaha nui ma kekahi ʻaoʻao, e hiolo ia, ʻeā? Pēlā nō ia. Hiki mai kēia maʻi i ka wā e nui loa ai ka waikawa o ko mākou kino a ʻaʻole lawa ka kumu e kāohi ai. I kekahi manawa hiki ke lilo kēia i maʻi ʻoluʻolu, akā i kekahi mau hihia hiki ke hoʻoweliweli i ke ola.
No ke aha e hana ai kēia? (Nā kumu o ka Metabolic Acidosis)
Aia kekahi mau kumu like ʻole e hiki ai ke hana ʻia kēia kaulike ʻole o ka waikawa-base i loko o ko kākou koko. E nānā kākou i nā kumu nui.
| Kumu | He wehewehe maʻalahi |
|---|---|
| Ketoacidosis ( ketoacidosis ) | Ke loaʻa ʻole i ke kanaka me ka maʻi diabetes ka insulin lawa a maloʻo loa, hoʻomaka ke kino e puhi i ka momona no ka ikehu. ʻO ka hopena kēia i ka hana ʻana o nā kemika i kapa ʻia he ketones. Ke hōʻiliʻili kēia mau ketones i loko o ke koko, lilo ke koko i waikawa. Hiki nō hoʻi ke ʻano o kēia maʻi i ka poʻe e inu nui ana i ka waiʻona, ʻaʻole ʻai pono, a i ʻole e hoʻokē ʻai ana. |
| ʻAkika Lactic | Ke loaʻa ʻole i nā ʻāpana o ko mākou kino ka oxygen lawa, hana lākou i kahi mea i kapa ʻia ʻo ka waikawa lactic. Hiki i kēia ke hōʻiliʻili i loko o ke koko. Hiki ke hana ʻia kēia i ka wā o ka hoʻoikaika kino nui, i ka wā e hāʻule koke ai ke koko, i nā hihia o ka hāʻule ʻana o ka puʻuwai, ka hopu ʻana o ka puʻuwai, a me nā maʻi nui. |
| Nā pilikia puʻupaʻa (Renal Tubular Acidosis) | Hoʻokahe nā puʻupaʻa olakino i nā waikawa keu mai ke koko a hoʻokuʻu iā lākou i loko o ka mimi. Eia nō naʻe, i ka wā e hōʻino ʻia ai nā puʻupaʻa ma muli o nā maʻi puʻupaʻa, kekahi mau maʻi ʻōnaehana pale, a me nā maʻi genetic, ʻaʻole hiki iā lākou ke hoʻopau pono i kēia mau waikawa. A laila noho nā waikawa i loko o ke koko. |
| ʻO ka Acidosis Hyperchloremic | ʻO ka maʻi palahēhē nui, ka hoʻohana pono ʻole ʻana i nā laxatives , a me kekahi mau maʻi puʻupaʻa e hiki ke hana i nā pae haʻahaʻa o ka bicarbonate i ko mākou kino. He kumu ka Bicarbonate e hoʻopau i nā waikawa. Ke haʻahaʻa, lilo ke koko i waikawa. |
He mea nui: Aia kekahi ʻano ʻē aʻe i kapa ʻia ʻo Respiratory Acidosis. I loko o kēia, lilo ke koko i ʻakika , akā ʻo ke kumu he pilikia i loko o nā māmā e hoʻoulu ai i ka hōʻiliʻili ʻana o ke kalapona ʻokikene keu i loko o ke kino. He ʻokoʻa kēia mai ka Metabolic Acidosis.
He aha nā hōʻailona o kēia? (Nā hōʻailona)
ʻOiai ke ʻokoʻa nā hōʻailona mai kēlā kanaka a kēia kanaka, he mau hōʻailona maʻamau kēia e ʻike ai kekahi kanaka me ka Metabolic Acidosis.
- Ka hanu wikiwiki : ʻO kēia no ka mea ke hoʻāʻo nei ke kino e hoʻokuke i ka waikawa keu (e like me ke kalapona ʻokikene) mai ke kino.
- Nā palpitations o ka puʻuwai
- ʻEha poʻo
- Manaʻo huikau (Confusion)
- Manaʻo o ka nāwaliwali
- Manaʻo luhi i nā manawa a pau
- Makemake nui
- Ka luaʻi a me ka luaʻi
He hōʻailona kaulana ka ʻala hua ma ka hanu , ʻoi aku hoʻi i ka diabetic ketoacidosis (DKA).
Inā loaʻa iā ʻoe kēia mau hōʻailona, e ʻike koke i kāu kauka. Inā manaʻo lākou he koʻikoʻi, mai hoʻokaʻulua i ka hele ʻana i ka Emergency Department (ETU) o ka haukapila.
Pehea e loaʻa ai iaʻu kēia? (Hoʻāʻo)
E hana ke kauka i kekahi mau hoʻokolohua e hoʻoholo pono ai inā loaʻa iā ʻoe kēia maʻi. A laila wale nō e hiki ai ke hāʻawi ʻia ka lāʻau kūpono.
- Hoʻāʻo Anion Gap: He hoʻāʻo kēia e ana i ke kaulike kemika o ke koko. I ka ʻōlelo maʻalahi, hoʻohālikelike ia i nā ʻāpana i hoʻopiʻi ʻia maikaʻi a maikaʻi ʻole (e like me ka sodium, chloride, bicarbonate) i loko o ke koko. I kekahi mau ʻano metabolic acidosis, ʻike nui ʻia ka "gap" ma waena o kēia mau waiwai.
- Hoʻāʻo ʻana i nā Kinoea Koko Arterial (ABG): Ke ana kēia i ka pH, a i ʻole ka acidity, a me nā pae oxygen a me ke kalapona dioxide o kou koko.
- Nā hoʻāʻo mimi: Hiki i kēia ke ʻike i nā ketones, nā pilikia puʻupaʻa, a i ʻole ka lāʻau make mai nā mea e like me ka aspirin, ka waiʻona, a i ʻole ka antifreeze. Hiki i ka poʻe me ka maʻi diabetes ke hoʻāʻo i kā lākou mimi no nā ketones ma ka home me ka hoʻohana ʻana i nā ʻāpana hoʻāʻo i loaʻa ma ka hale kūʻai lāʻau lapaʻau.
Pehea e mālama ai? (Lapaʻau)
Hoʻōla ʻia ka Metabolic Acidosis ma ka mālama ʻana i ke kumu kumu. E noʻonoʻo e like me ka wai e liki ana ma luna o ka hale. ʻOi aku ka maikaʻi o ka hoʻoponopono ʻana i ka lua ma ka hale ma mua o ka waiho ʻana i kahi bākeke a hopu i ka wai. Pēlā ia.
Inā ʻaʻole i kāohi ʻia kēia kūlana, hiki iā ia ke hoʻopilikia i kou mau iwi, nā ʻiʻo, a me nā puʻupaʻa. I nā hihia koʻikoʻi, hiki ke loaʻa ka haʻalulu a me ka make. Hiki i kahi kūlana e like me DKA ke alakaʻi i kahi coma.
No laila, he mea nui loa ka ʻimi ʻana i ka lāʻau lapaʻau i ka wā hikiwawe loa . ʻO kekahi o nā lāʻau lapaʻau i kuhikuhi pinepine ʻia:
- Hoʻomaʻemaʻe ʻana i ka ʻawaʻawa: Inā loaʻa kēia ʻano ma muli o ka lāʻau make a i ʻole ka waiʻona, hāʻawi ʻia ka lāʻau lapaʻau e wehe i ka lāʻau make mai ke kino. Inā manaʻo ʻoe ua loaʻa kekahi lāʻau make, e kelepona koke i ke Kikowaena ʻIke Lāʻau Make ma ka Halemai Lahui ʻo Colombo no ka ʻōlelo aʻoaʻo.
- ʻInisulina: Hāʻawi ʻia ka ʻinisulina no DKA i hoʻokumu ʻia e ka maʻi diabetes.
- Nā wai intravenous (nā wai IV): Hāʻawi ʻia nā wai e like me ka saline ma o kahi aʻa koko i loko o kou lima.
- Sodium bicarbonate: I kekahi mau hihia, hāʻawi ʻia kēia lāʻau lapaʻau ma o kahi vein e hoʻonui i ka alkalinity o ke koko.
Pono paha ʻoe e lawe ʻia i ka haukapila.
Pehea e pale ai iā ʻoe iho mai kēia kūlana? (Ka pale ʻana)
ʻOiai ʻaʻole hiki ke pale ʻia ka metabolic acidosis i nā manawa a pau, aia kekahi mau mea hiki iā ʻoe ke hana e hōʻemi i kou pilikia.
- E inu i ka nui o ka wai a me nā wai ʻona ʻole. Inā moakaka a melemele paha kou mimi, ʻo ia hoʻi ke loaʻa nei iā ʻoe ka wai lawa.
- E kaupalena i ka waiʻona. Hiki i ka waiʻona ke hoʻonui i ka hōʻiliʻili ʻakika i loko o ke kino a hoʻoulu i ka maloʻo.
- Inā loaʻa iā ʻoe ka maʻi diabetes, e kāohi pono iā ia. E hahai pono i nā ʻōlelo a kāu kauka.
- I ka wā e lawe ai i ka lāʻau lapaʻau, e hahai pono i nā ʻōlelo aʻo a kāu kauka a i ʻole ma ka pūʻolo.
Leka Lawe-Home
- ʻO ka metabolic acidosis kahi hoʻopilikia i ke kaulike acid-base i loko o kou koko. Mai lawe māmā i kēia.
- Inā loaʻa iā ʻoe nā hōʻailona e like me ka hanu wikiwiki, ka huikau, a me ka luhi nui, hiki ke hōʻailona ia o kahi pilikia nui i loko o ke kino.
- Hoʻōla ʻia kēia ma ka mālama ʻana i ke kumu kumu (e like me ka maʻi diabetes, ka maʻi puʻupaʻa, ka lāʻau make).
- Inā he kānalua a he mau hōʻailona paha kāu, mai kuhi wale. E ʻike koke i kāu kauka no ka ʻōlelo aʻo kūpono a me ka lāʻau lapaʻau.
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